Medical Physiology Commons^™

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

The Role Of Microglia In Neuroinflammation Of The Spinal Cord After Peripheral Nerve Injury, Tana S. Pottorf, Travis M. Rotterman, William M. Mccallum, Zoë A. Haley-Johnson, Francisco J. Alvarez

Neuroscience, Cell Biology & Physiology Faculty Publications

Peripheral nerve injuries induce a pronounced immune reaction within the spinal cord, largely governed by microglia activation in both the dorsal and ventral horns. The mechanisms of activation and response of microglia are diverse depending on the location within the spinal cord, type, severity, and proximity of injury, as well as the age and species of the organism. Thanks to recent advancements in neuro-immune research techniques, such as single-cell transcriptomics, novel genetic mouse models, and live imaging, a vast amount of literature has come to light regarding the mechanisms of microglial activation and alluding to the function …

Sinus Pauses And Asystole As A Rare Presentation Of Thyrotoxic Crisis: A Case Report, Christian Akem Dimala, Charnjeet Sandhu, Oreoluwa Oladiran, Agnieszka Mochon, William Finneran Iii

Transformative Medicine

Introduction

Thyroid crisis is a rare and life-threatening endocrine emergency characterized by exaggerated clinical manifestations of hyperthyroidism with cardiovascular manifestations being the most severe. Rhythm disturbances, sinus tachycardia and atrial fibrillation, are the commonest cardiac manifestations of severe thyrotoxicosis; however, asystole remains a very atypical and uncommon presentation. We present a case of thyrotoxicosis due to Grave’s disease complicated by multiple episodes of asystole.

Case Presentation

A 65-year-old female recently diagnosed with Grave’s disease presented to the hospital with recurrent episodes of syncope. Her hospital course was significant for atrial fibrillation with subsequent progression to sinus pauses and asystole spontaneously …

Lysosomal Zn 2+ Release Triggers Rapid, Mitochondria-Mediated, Non-Apoptotic Cell Death In Metastatic Melanoma, Wanlu Du, Mingxue Gu, Meiqin Hu, Timothy Nold, Prateeksunder Pinchi, Wei Chen, Michael Ryan, Ahmed Bannaga, Haoxing Xu

Medical Student Research Symposium

During tumor progression, lysosome function is often maladaptively upregulated to match the high energy demand required for cancer cell hyper-proliferation and invasion. Here, we report that mucolipin TRP channel 1 (TRPML1), a lysosomal Ca2+ and Zn2+ release channel that regulates multiple aspects of lysosome function, is dramatically upregulated in metastatic melanoma cells compared with normal cells. TRPML-specific synthetic agonists (ML-SAs) are sufficient to induce rapid (within hours) lysosomal Zn2+-dependent necrotic cell death in metastatic melanoma cells while completely sparing normal cells. ML-SA-caused mitochondria swelling and dysfunction lead to cellular ATP depletion. While pharmacological inhibition or genetic silencing of TRPML1 in …

Il-10 And Tgf-Β Increase Connexin-43 Expression And Membrane Potential Of Hl-1 Cardiomyocytes Coupled With Raw 264.7 Macrophages, Cora B. Cox, Mike Castro, Thomas L. Brown, Nancy J. Bigley

Neuroscience, Cell Biology & Physiology Faculty Publications

Cardiac resident macrophages facilitate electrical conduction by interacting with cardiomyocytes via connexin-43 (Cx43) hemichannels. Cx43 is critical for impulse propagation and coordination between muscle contractions. Cardiomyocyte electrophysiology can be altered when coupled with noncardiomyocyte cell types such as M2c tissue-resident macrophages. Using cocultures of murine HL-1 cardiomyocytes and RAW 264.7 macrophages, we examined the hypothesis that cytokine signals, TGF-β1 and IL-10, upregulate Cx43 expression at points of contact between the two cell types. These cytokine signals maintain the macrophages in an M2c anti-inflammatory phenotype, mimicking cardiac resident macrophages. The electrophysiology of cardiomyocytes was examined using di-8-ANEPPS potentiometric dye, which reflects …

Antigen Staining For Detection Of Muc13 And Muc16 Expression In Carcinoma Tissue, Jose A. Benitez

MEDI 9331 Scholarly Activities Clinical Years

MUC13 and MUC16 are epithelial expressed proteins implicated in various carcinomas. Overexpression of these biomarkers appear to play a role in tumor growth; this discovery has paved a road for multiple studies discussing the potential of targeting mucin proteins and optimize immunotherapy approaches against carcinomas. Our study serves to investigate the level of expression of MUC13 and MUC16 in cancerous and normal tissue and to discuss the implications our findings may have for the utilization of these biomarkers for cancer therapy.

Alcohol Impairs Immunometabolism And Promotes Naïve T Cell Differentiation To Pro-Inflammatory Th1 Cd4+ T Cells, Patrick M. Mcternan, Danielle E. Levitt, David A. Welsh, Liz Simon, Robert W. Siggins, Patricia E. Molina

School of Medicine Faculty Publications

CD4+ T cell differentiation to pro-inflammatory and immunosuppressive subsets depends on immunometabolism. Pro-inflammatory CD4+ subsets rely on glycolysis, while immunosuppressive Treg cells require functional mitochondria for their differentiation and function. Previous pre-clinical studies have shown that ethanol (EtOH) administration increases pro-inflammatory CD4+ T cell subsets; whether this shift in immunophenotype is linked to alterations in CD4+ T cell metabolism had not been previously examined. The objective of this study was to determine whether ethanol alters CD4+ immunometabolism, and whether this affects CD4+ T cell differentiation. Naïve human CD4+ T cells were plated on anti-CD3 coated plates with soluble anti-CD28, and …

Modulating Cardiac Remodeling After Myocardial Infarction, Upendra Chalise

Theses & Dissertations

Cardiac remodeling after myocardial infarction (MI) is indicated by infarct wall thinning, reduced ejection fraction, and dilation of the left ventricle (LV). Inflammation presides in the early days of MI as a key event in cardiac wound healing. Infiltration of inflammatory cells, predominantly neutrophils and macrophages, is stimulated by ischemic cardiomyocytes that secrete inflammatory cues. This dissertation focused on identifying factors that influence cardiac remodeling after MI. S100A9 is a neutrophil-derived factor identified that exacerbated infarct wall thinning and cardiac dilation by increasing neutrophil and macrophage infiltration. Similarly, murinoglobulin 1 (Mug1) and galectin (Lgals)3 were macrophage-derived factors identified that regulate …

Tourniquet-Induced Ischemia-Reperfusion Injury, Junliang Qian

Theses & Dissertations

Ischemia-reperfusion (IR) is a pathological condition characterized by an initial restriction of blood supply to an organ followed by subsequent restoration of reperfusion associated with exacerbation of tissue damage. For pre-hospital emergency situations and surgical procedures, tourniquet or femoral artery ligation are widely used to stop extremity hemorrhage or create a bloodless operating field. To fully evaluate the underlying mechanisms in IR pathophysiology and potential therapeutic options, we compared tourniquet- and femoral artery ligation-induced IR injuries in the hindlimb of mice. We found that tourniquet/IR-induced acute hindlimb injuries are more severe than those induced by femoral artery ligation/IR, including alteration …

Admission Pao2 And Mortality Among Pediatric Icu Patients And Critically Ill Subgroups, Cara Holton

Research Days

Watch recording of live presentation

Background and Objectives: Studies analyzing the association between hyperoxia and mortality in critically ill pediatric patients and those admitted after cardiac arrest are conflicting and limited by small sample sizes. The aim of this study is to evaluate the association between PaO2 on admission to the pediatric ICU and mortality in a heterogeneous, multicenter cohort and among subgroups of critically ill patients.

Methods/Design: A retrospective cohort study was conducted using data from Virtual Pediatric Systems (VPS) database. VPS is a clinical pediatric critical care database with over 135 participating hospitals in North America. All VPS …

Diurnal Regulation Of Exercise-Induced Myocardial Signaling And Transcription, Charli Aguilar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Exercise is well known for its many benefits on the body and most notably the heart. Recent emphasis, and significant resources, have been dedicated to elucidating the molecular mechanisms through which exercise exerts its pluripotent beneficial effects on health and the prevention of disease. A continuous evolution in this field has sought to modulate and optimize exercise in various ways to maximize the benefits. In recent years, a growing appreciation for the impact of circadian rhythms has gained traction and their influence on many essential biological functions have been integrated into exercise physiology (i.e. - chrono-exercise), as well as …

A Neurophysiological Investigation Of Listening Effort In Normal Hearing Adults Using Fnirs And Pupillometry, Jessica Defenderfer

Theses and Dissertations (ETD)

Real-world conversations are often accompanied by some sort of interference that challenges the clarity of the speaker’s message, causing listeners to exert more effort to understand speech. Previous research has demonstrated that when listening to speech becomes difficult, various regions of the brain are recruited beyond those which engage during optimal listening conditions. However, the neural correlates that underly listening effort are not fully understood. Importantly, the pupillary response can be used to index listening effort, such that pupil size increases with increasing cognitive demand. I proposed that pupillometry can be used to characterize the cortical response, such that changes …

Sight Deprivation And Metabolic Effects During The Ymca Bench Press Test, Kyle Cruz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Several studies have investigated the effect of sensory deprivation, particularly sight. However, very few have demonstrated the impact of sight deprivation while exercising to cadence blindfolded. This study aimed to determine exercise performance during a common muscular endurance evaluation, the YMCA Bench Press Test (YBPT), while blindfolded compared to a sighted condition. Twenty-five healthy participants (11 male, 14 female, 168 ± 7.7cm, 68 ± 11.7kg, 23 ± 7.5% fat mass) were recruited from the University of Nevada, Las Vegas student populations and communities. After a YBPT familiarization session, participants completed testing in a counterbalanced order, following the same procedures. A …

At-Home Aerobic Exercise Improves Functional Ability Of Patients With Rheumatoid Arthritis With Limited Exercise Options, Daniel Harris

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Neuberger GB, Aaronson LS, Gajewski B, et al. Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. Arthritis Rheum. 2007;57(6):943-952. https://doi.org/10.1002/art.22903

and its application for a patient with rheumatoid arthritis.

Short-Term Muscle Fatigue And Recovery In Different Types Of Athletes, Morgan D. Morris, Jayson C. Sumner, Aaron F. Valenti

ONU Student Research Colloquium

Having poor grip strength can cause an increase of injuries and difficulty to perform day to day tasks. The goal of this IRB approved research was to investigate how athletic sport activities impact muscle fatigue and recovery in grip strength. The study consisted of ten males between the ages of 18 and 24 from four different collegiate sport teams: (1) wrestlers, (2) football players, (3) e-sports players, and (4) basketball players, at Ohio Northern University. For each athlete, grip strength (pounds per square inch) was measured before and after squeezing a 60 kg. grip strengthener 30 times to induce muscle …

Acute Oxygen-Sensing Via Mitochondria-Generated Temperature Transients In Rat Carotid Body Type I Cells, Ryan J. Rakoczy, Clay M. Schiebrel, Christopher N. Wyatt

Neuroscience, Cell Biology & Physiology Faculty Publications

The Carotid Bodies (CB) are peripheral chemoreceptors that detect changes in arterial oxygenation and, via afferent inputs to the brainstem, correct the pattern of breathing to restore blood gas homeostasis. Herein, preliminary evidence is presented supporting a novel oxygen-sensing hypothesis which suggests CB Type I cell “hypoxic signaling” may in part be mediated by mitochondria-generated thermal transients in TASK-channel-containing microdomains. Distances were measured between antibody-labeled mitochondria and TASK-potassium channels in primary rat CB Type I cells. Sub-micron distance measurements (TASK-1: 0.33 ± 0.04 µm, n = 47 vs TASK-3: 0.32 ± 0.03 µm, n = …

A Practical Approach To Assessing Physical Freshness: Utility Of A Simple Perceived Physical Freshness Status Scale, Okba Selmi, Danielle E. Levitt, Filipe Manuel Clemente, Hadi Nobari, Giulia My, Antonella Muscella, Katsuhiko Suzuki, Anissa Bouassida

School of Medicine Faculty Publications

Background: Monitoring physical freshness is essential in assessing athletes’ conditions during training periods, training sessions, or competitions. To date, no single physical freshness scale has been successfully validated against training load variables and widely used scales measuring different facets of physical freshness. Objective: In this study, we develop and test the practical utility of a perceived physical freshness (RPF) scale to monitor the condition of the athletes and to prevent excessive fatigue and insufficient recovery during training sessions or competitions. Methods: Sixteen professional male soccer players (mean ± SD age 26 ± 4 years) were enrolled. Training load (TL), monotony, …

Parkinson's Disease And Exercise: Steps Into A Hopeful Future, Jacob Barker

Spring Showcase for Research and Creative Inquiry

In the world of medicine and disease interventions, exercise is too often underlooked as a viable form of treatment or complementary treatment to medication. This is especially true with Parkinson’s Disease, a disease that attacks the basal ganglia of the brain and impairs neuromuscular function. In my analysis, I read a perspective from a PD patient, Gerry Hill, who has struggled with the disease himself and how he used physical activity to aid in his battle with the disease for both physical and psychological aid. Additionally, I performed research to understand how exercise benefits function within the brain. Aerobic exercise, …

The Pathology And Treatment Of Osteoporosis, Shea Munnikhuysen

Senior Honors Theses

Osteoporosis is a disease that causes bone fragility and decreased bone mass. Osteocytes and signaling molecules regulate the function of osteoclasts and osteoblasts. The RANK pathway is a key regulator in osteoclastogenesis. When the osteoclastic function is greater than osteoblastic function, bone integrity decreases. Causes of osteoporosis include hormones, medications, and diet. Treatments for osteoporosis are hormonal, medicinal, and lifestyle changes. More research needs to be done to find more effective medications with fewer negative side effects to improve the overall quality of life for patients. Currently, lab trials are being done on potential new medications to treat osteoporosis.

A Rodent Animal Model For Forelimb To Lower Jaw Reorganization In Primary Somatosensory Cortex (Si) Barrel Field, Violeta Pellicer Morata

Theses and Dissertations (ETD)

The goal of this study is to examine mechanisms underlying cortical reorganization in rat primary somatosensory (SI) cortex that follows forelimb deafferentation. The majority of human patients suffering from limb loss or brachial plexus avulsion injury, as well as patients that receive brachial plexus anesthesia, report phantom limb sensations/pain which are often associated with cortical reorganization. Patients with upper-limb deafferentation report sensations of the missing hand during tactile stimulation of the face, and this phenomenon has been termed hand-to-face remapping. We sought to develop a rodent model of deafferentation; our model system is the rat SI cortex barrel field present …

The Anti-Inflammatory Agent Bindarit Attenuates The Impairment Of Neural Development Through Suppression Of Microglial Activation In A Neonatal Hydrocephalus Mouse Model, Eri Iwasawa, Farrah N. Brown, Crystal Shula, Fatima Kahn, Sang Hoon Lee, Temugin Berta, David R. Ladle, Kenneth Campbell, Francesco T. Mangano, June Goto

Neuroscience, Cell Biology & Physiology Faculty Publications

Neonatal hydrocephalus presents with various degrees of neuroinflammation and long-term neurologic deficits in surgically treated patients, provoking a need for additional medical treatment. We previously reported elevated neuroinflammation and severe periventricular white matter damage in the progressive hydrocephalus (prh) mutant which contains a point mutation in the Ccdc39 gene, causing loss of cilia-mediated unidirectional CSF flow. In this study, we identified cortical neuropil maturation defects such as impaired excitatory synapse maturation and loss of homeostatic microglia, and swimming locomotor defects in early postnatal prh mutant mice. Strikingly, systemic application of the anti-inflammatory small molecule bindarit significantly supports healthy …

Friend Of The Devil: Negative Social Influences Driving Substance Use Disorders, Matthew B. Pomrenze, Franciely Paliarin, Rajani Maiya

School of Medicine Faculty Publications

Substance use disorders in humans have significant social influences, both positive and negative. While prosocial behaviors promote group cooperation and are naturally rewarding, distressing social encounters, such as aggression exhibited by a conspecific, are aversive and can enhance the sensitivity to rewarding substances, promote the acquisition of drug-taking, and reinstate drug-seeking. On the other hand, withdrawal and prolonged abstinence from drugs of abuse can promote social avoidance and suppress social motivation, accentuating drug cravings and facilitating relapse. Understanding how complex social states and experiences modulate drug-seeking behaviors as well as the underlying circuit dynamics, such as those interacting with mesolimbic …

Β-Aminopropionitrile-Induced Aortic Aneurysm And Dissection In Mice, Hisashi Sawada, Zachary A. Beckner, Sohei Ito, Alan Daugherty, Hong S. Lu

Saha Cardiovascular Research Center Faculty Publications

The mechanistic basis for the formation of aortic aneurysms and dissection needs to be elucidated to facilitate the development of effective medications. β-Aminopropionitrile administration in mice has been used frequently to study the pathologic features and mechanisms of aortic aneurysm and dissection. This mouse model mimics several facets of the pathology of human aortic aneurysms and dissection, although many variables exist in the experimental design and protocols that must be resolved to determine its application to the human disease. In the present brief review, we have introduced the development of this mouse model and provided insights into understanding its pathologic …

Long-Lasting Impairments In Quadriceps Mitochondrial Health, Muscle Size, And Phenotypic Composition Are Present After Non-Invasive Anterior Cruciate Ligament Injury, Steven M. Davi, Ahram Ahn, Mckenzie S. White, Timothy A. Butterfield, Kate Kosmac, Oh Sung Kwon, Lindsey K. Lepley

Center for Muscle Biology Faculty Publications

Introduction: Despite rigorous rehabilitation aimed at restoring muscle health, anterior cruciate ligament (ACL) injury is often hallmarked by significant long-term quadriceps muscle weakness. Derangements in mitochondrial function are a common feature of various atrophying conditions, yet it is unclear to what extent mitochondria are involved in the detrimental sequela of quadriceps dysfunction after ACL injury. Using a preclinical, non-invasive ACL injury rodent model, our objective was to explore the direct effect of an isolated ACL injury on mitochondrial function, muscle atrophy, and muscle phenotypic transitions.

Methods: A total of 40 male and female, Long Evans rats (16-week-old) were exposed to …

Gut Microbiome And Metabolome Variations In Self-Identified Muscle Builders Who Report Using Protein Supplements, Lauri O. Byerley, Karyn M. Gallivan, Courtney J. Christopher, Christopher M. Taylor, Meng Luo, Scot E. Dowd, Gregory M. Davis, Hector F. Castro, Shawn R. Campagna, Kristin S. Ondrak

School of Graduate Studies Faculty Publications

Muscle builders frequently consume protein supplements, but little is known about their effect on the gut microbiota. This study compared the gut microbiome and metabolome of selfidentified muscle builders who did or did not report consuming a protein supplement. Twenty-two participants (14 males and 8 females) consumed a protein supplement (PS), and seventeen participants (12 males and 5 females) did not (No PS). Participants provided a fecal sample and completed a 24-h food recall (ASA24). The PS group consumed significantly more protein (118 ± 12 g No PS vs. 169 ± 18 g PS, p = 0.02). Fecal metabolome and …

Rethinking Integration Of Environmental And Behavioral Stressors; Back To Energy Homeostasis And Function, Patricia E. Molina

School of Medicine Faculty Publications

No abstract provided.

T-Lymphocyte Tyrosine Hydroxylase Regulates T H 17 T-Lymphocytes During Repeated Social Defeat Stress, Safwan K. Elkhatib, Cassandra M. Moshfegh, Gabrielle F. Watson, Adam J. Case

Journal Articles: Cellular & Integrative Physiology

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder which results in deleterious changes to psychological and physical health. Patients with PTSD are especially susceptible to life-threatening co-morbid inflammation-driven pathologies, such as autoimmunity, while also demonstrating increased T-helper 17 (T_H17) lymphocyte-driven inflammation. While the exact mechanism of this increased inflammation is unknown, overactivity of the sympathetic nervous system is a hallmark of PTSD. Neurotransmitters of the sympathetic nervous system (i.e., catecholamines) can alter T-lymphocyte function, which we have previously demonstrated to be partially mitochondrial redox-mediated. Furthermore, we have previously elucidated that T-lymphocytes generate their own catecholamines, and strong …

User Experience In The Visual Notifications On Smart Devices, Young Ae Kim

Dissertations and Theses

Notifications on smart devices have a crucial role for the end-users to help decide their action to the information. Despite the flexible customization of notifications for the intuitive user experience, users feel overwhelmed by the number of notifications they receive daily. The nature of notifications is short-lived, but they are extremely intrusive and disengaging. While user experience and user interface are advanced, notifications have remained broken despite their complexity. In fact, the notifications have the poorest usability that users may struggle to customize notifications in their smart devices and choose to ignore them. Irrelevant notifications not only get ignored, but …

Strong Inferences About Pain In Invertebrates Require Stronger Evidence, Edgar T. Walters

Animal Sentience

Evidence for sentience in animals distantly related to humans is often sought in observations of behavioral and neural responses to noxious stimuli that would be painful in humans. Most proposed criteria for painful sentience in “lower” animals such as decapod crustaceans have no necessary links to the affective (“suffering”) component of pain. The best evidence for painful affect in animals is learned aversion to stimuli associated with noxious experience, and conditioned preference for contexts associated with relief from aversive consequences of noxious experience, as expressed in voluntary behavior. Such evidence is currently lacking for any invertebrate except octopus.

Comparative Genomics, Evolutionary Epidemiology, And Rbd-Hace2 Receptor Binding Pattern In B.1.1.7 (Alpha) And B.1.617.2 (Delta) Related To Their Pandemic Response In Uk And India, Chiranjib Chakraborty, Ashish Ranjan Sharma, Manojit Bhattacharya, Bidyut Mallik, Shyam Sundar Nandi, Sang-Soo Lee

Journal Articles: Cellular & Integrative Physiology

BACKGROUND: The massive increase in COVID-19 infection had generated a second wave in India during May-June 2021 with a critical pandemic situation. The Delta variant (B.1.617.2) was a significant factor during the second wave. Conversely, the UK had passed through the crucial phase of the pandemic from November to December 2020 due to B.1.1.7. The study tried to comprehend the pandemic response in the UK and India to the spread of the B.1.1.7 (Alpha, UK) variant and B.1.617.2 (Delta, India) variant.

METHODS: This study was performed in three directions to understand the pandemic response of the two emerging variants. First, …